胸腔镜膈疝修补术和传统开放性手术在新生儿先天性膈疝中的对比研究

摘要

目的 对比分析胸腔镜膈疝修补术和传统开放性手术在新生儿先天性膈疝中的疗效.方法 选取2012年6月-2015年5月在河南省南阳市中心医院进行治疗的86例新生儿先天性膈疝患儿作为研究对象,将行胸腔镜膈疝修补术患儿纳入观察组,行传统开放性手术患儿纳入对照组,各43例.观察两组患儿手术时间、术中出血量、切口长度、术后机械通气时间、术后抗生素使用时间、住院时间等手术指标以及生存率、复发率、并发症发生率.结果 手术时间、术中出血量、切口长度、术后机械通气时间、术后抗生素使用时间、住院时间以及术后进食时间观察组数据均优于对照组患儿(<0.05),术后胸腔积液及24 h血氧饱和度(PCO2)与对照组比较差异无统计学意义(>0.05).观察组患儿术后并发症发生率2.33%低于对照组13.95%,但差异无统计学意义(>0.05),而两组复发率及生存率差异也无统计学意义(>0.05).结论 胸腔镜膈疝修补术相比传统开放性手术在新生儿先天性膈疝中效果更加显著.%Objective To compare and analyze the treatment effect of thoracoscopic surgery and traditional open surgery for repair of congenital diaphragmatic hernia in neonates. Methods The research subjects included 86 neonates with congenital diaphragmatic hernia treated in our hospital from June 2012 to May 2015, and the children treated with thoracoscopic repair of diaphragmatic hernia were noted as the observation group, and those treated with traditional open surgery were noted as the control group, with 43 cases in each group. The operation indexes such as operation time, intraoperative bleeding volume, incision length, postoperative mechanical ventilation time, postoperative antibiotic use time and hospital stay, as well as survival rate, recurrence rate and incidences of complications were observed in the two groups. Results The operation indexes such as operative time, intraoperative blood loss, incision length, postoperative mechanical ventilation time, postoperative antibiotic use time, hospital stay and postoperative eating time in the observation group were significantly better than those in the control group ( <0.05). The differences in pleural effusion and 24-h PCO2 after operation were not statistically significant compared with those in the control group ( >0.05). The incidence of complications in the observation group was 4.65%, lower than that of 13.95%in the control group, but the difference was not statistically significant ( > 0.05). There was no significant difference in the recurrence rate or survival rate between the two groups ( > 0.05). Conclusions The effect of thoracoscopic repair of diaphragmatic hernia is more significant than that of traditional open surgery in neonates with congenital diaphragmatic hernia.